Vitrectomy system

Abstract

The invention relates to a vitrectomy system (1) comprising a pneumatically operated surgical instrument (2), a console (3) configured to provide compressed air for operating the surgical instrument (2), and at least one pneumatic line (4) connecting the surgical instrument (2) to the console (3) and through which the compressed air is provided, wherein the at least one pneumatic line (4) has a section (4-1) away from the instrument and a section (4-2) near the instrument, wherein the inner diameters (5-1, 5-2) of the sections (4-1, 4-2) of the pneumatic line (4) are the same, and wherein the outer diameter (6-1, 6-2) and / or the material damping of the two sections (4-1, 4-2) differ.

Description

[0001] In the field of vitrectomy, systems are known in which a vitrectome is pneumatically operated. Typically, pneumatically operated vitrectomes are connected to a console via a pneumatic line; in the case of dual-pneumatic systems, two pneumatic lines may be used. To effect the alternating movement of a cutting edge of the vitrectome, the console uses a switching device to alternately pressurize and vent the pneumatic line. This results in pressure losses (on the order of 1 bar) along the line to the vitrectome, which impede both rapid pressurization and venting. This limits the maximum possible cutting rate. To compensate, for example, a higher pressure is applied, or venting is accelerated by applying a vacuum.These countermeasures result in an increase in the standard liter consumption, which pushes the limits of an internal console compressed air supply via a compressor, so that for high cutting rates an external compressed air supply often has to be used.

[0002] US 2013 / 0150875A1 describes a system comprising a pneumatic surgical instrument and a surgical console that supplies compressed air to the pneumatic surgical instrument. The system also includes a pneumatic drive line connecting the pneumatic surgical instrument to the surgical console. The pneumatic drive line has an internal bore that serves to direct the compressed air to the pneumatic surgical instrument. The internal bore has a non-uniform cross-section along the length of the pneumatic drive line.

[0003] A vitrectomy probe is known from EP 3 600 184 B1. The vitrectomy probe comprises an inner cutting tube that moves back and forth within an outer tube. The outer tube has a side port, and the inner tube has a distal cutting port and, in some embodiments, an additional side port. In some embodiments, the inner tube may also have a flat top edge that intersects the side port of the outer tube. In some embodiments, a diaphragm drives the inner tube and may have an open-stroke side made of a material with lower hardness than a closed-stroke side. In some embodiments, an aspiration tube connected to the vitrectomy probe may comprise a first aspiration tube and a second aspiration tube with a lower hardness than the first aspiration tube.In some embodiments, the vitrectomy probe can be connected to a stepped or conical pneumatic tube.

[0004] The invention is based on the objective of improving a vitrectomy system.

[0005] The problem is solved according to the invention by a vitrectomy system with the features of claim 1. Advantageous embodiments of the invention are set forth in the dependent claims.

[0006] In particular, a vitrectomy system is created comprising a pneumatically operated surgical instrument, a console configured to provide compressed air for operating the surgical instrument, and at least one pneumatic line connecting the surgical instrument to the console and through which the compressed air is provided, wherein the at least one pneumatic line has a section far from the instrument and a section close to the instrument, wherein the inner diameters of the sections of the pneumatic line are the same, and wherein the outer diameter and / or material damping of the two sections is different.

[0007] The vitrectomy system, in particular, enables the smooth, step-free transmission of a compressed air pressure wave from the console to the surgical instrument. Different inner diameters, as described in the prior art, can lead to pressure losses when the compressed air pressure wave passes over the resulting constriction, causing partial reflections. Furthermore, the vitrectomy system allows for the optimization of the pneumatic line's properties according to the specific requirements of each section. Specifically, the properties of the section furthest from the instrument and the section closest to it can be independently adjusted by selecting the outer diameter and / or the material insulation, thus enabling optimization according to different objectives.The design specifically aims to minimize pressure loss in the section furthest from the instrument and maximize flexibility in the section closest to the instrument to facilitate handling of the surgical instrument. Overall, this approach reduces pressure loss while ensuring good handling (ergonomics) of the surgical instrument, thereby increasing the resection rate of the vitrectomy system.

[0008] The surgical instrument is, in particular, a vitrectomy, specifically a pneumatically operated vitrectomy. It may be designed to operate the vitrectomy pneumatically via one pneumatic line or via two pneumatic lines, i.e., dual-pneumatically. In the first case, the vitrectomy system has one pneumatic line; in the second case, it has two.

[0009] The length of the pneumatic line(s) is selected such that the section furthest from the instrument is longer than the section closest to the instrument. For example, with a total pneumatic line length of 2 meters, the section furthest from the instrument may be 1.80 meters long and the section closest to the instrument 0.2 meters long. The section furthest from the instrument may, for example, be made of or comprise polyurethane (PU). The inner diameter of both the section furthest from the instrument and the section closest to the instrument may, for example, be 2 mm. The outer diameter of the section furthest from the instrument may, for example, be 5 mm and the loss factor may, in particular, be 0.05. The section closest to the instrument may, for example, be made of or comprise silicone. The outer diameter of the section closest to the instrument may, for example, be 3.5 mm and the loss factor may, in particular, be 0.2.

[0010] In one embodiment, the material damping of the section furthest from the instrument is lower than that of the section closest to the instrument. This reduces pressure loss in the section furthest from the instrument and allows for a flexible pneumatic line in the section closest to the instrument. Since the section closest to the instrument is significantly shorter, the pressure loss in this section is less critical than in the section furthest from the instrument. The section furthest from the instrument can, for example, be made of or comprise polyurethane (PU). The section furthest from the instrument can, for example, have a loss factor in the range of, in particular, 0.05–0.15. The section closest to the instrument can, for example, be made of or comprise silicone. The section closest to the instrument can, for example, have a loss factor in the range of, in particular, 0.2–0.4.

[0011] In one embodiment, the wall thickness of the sections, defined by their outer and inner diameters, is selected such that the bending stiffness of the section closest to the instrument is lower than that of the section furthest from the instrument. This allows for greater flexibility in the section closest to the instrument and sufficient stiffness in the radial direction of the pneumatic line in the section furthest from the instrument. This minimizes radial expansion of the pneumatic line caused by alternating pressure and thus also reduces pressure losses in this section. The section furthest from the instrument can, for example, be made of or comprise polyurethane (PU). The section furthest from the instrument can, for example, have a bending stiffness in the range of 125–250 N / mm². 2The section closest to the instrument can, for example, be made of or comprise silicone. The section closest to the instrument can, for example, have a flexural stiffness in the range of 1.5–15 Nmm. 2 exhibit.

[0012] In one embodiment, the length of the sections is selected, taking into account a cutting rate, such that an antinode of the compressed air is created at the surgical instrument. This results in particularly good coupling to the surgical instrument. The exact values ​​can be determined, in particular, through simulations and / or tests. A rough estimate, neglecting pressure losses, suggests that for a total section length of 2 m, a cutting rate of 10,000 strokes per minute and a drive pressure of 3.77 bar could be selected.

[0013] In one embodiment, the vitrectomy system is provided with a fastening device for attaching the at least one pneumatic line to a user of the surgical instrument, with the fastening device being located at the contact point of the sections. This allows for particularly ergonomic handling of the surgical instrument. For example, the fastening can be positioned near the user's hand. Especially if the section closest to the instrument is more flexible, this enables particularly energy-efficient and ergonomic handling of the surgical instrument.On the other hand, the section furthest from the instrument can be optimized for minimal pressure loss, for example, by selecting greater flexural stiffness, lower material damping, and / or a larger outer diameter. Because of the attachment to the user, the typically associated reduced flexibility hardly affects the handling of the surgical instrument. The attachment can also provide a kind of strain relief between the two sections of the pneumatic tubing, so that the movement of the section of the pneumatic tubing closest to the instrument and the surgical instrument is not, or only minimally, affected by the properties of the section furthest from the instrument. The attachment device can, for example, be positioned on the user's wrist or forearm.However, other mounting locations are also possible. The mounting device can be made of plastic and / or metal.

[0014] In one embodiment, the fastening device includes at least one connecting section designed to fluidically connect the sections of the pneumatic line. This allows for direct fastening at the interface between the section furthest from the instrument and the section closest to it. This enables, in particular, optimal decoupling of the properties of the two sections, thus optimally reducing pressure loss in the section furthest from the instrument while simultaneously maximizing flexibility in the section closest to it. Specifically, with regard to parameter optimization, the position of the strain relief provided by fastening to the user can be optimally selected.

[0015] In one embodiment, the fastening device includes a fastening strap. This allows the fastening to be achieved by wrapping the strap around a part of the user's body, such as the wrist or forearm. A fastening element may be provided for attaching the pneumatic line to the fastening strap. For this purpose, the fastening element has, in particular, an elongated hole to accommodate the fastening strap. The fastening element may also be designed to connect sections of the pneumatic line and may, for this purpose, have at least one connecting section. The fastening element may, for example, be manufactured as an injection-molded part.

[0016] In one embodiment, the fastening strap is provided with a hook-and-loop fastener. This makes it particularly easy to attach and detach the fastening strap.

[0017] In one embodiment, the fastening device includes a retaining clip. This allows for a simple attachment that is easy to form and release, particularly on a garment worn by the user. The retaining clip may have a lower jaw and an upper jaw, which can be used to grip a section of the garment. The lower and upper jaws may have alternating and / or interlocking teeth for this purpose. For example, the retaining clip may be designed to allow the distance between the lower and upper jaws to be adjusted. A material- and / or structural restoring force may move the lower and / or upper jaws from an open position back into a holding position. The retaining clip may be manufactured, for example, as an injection-molded part.

[0018] In one embodiment, the fastening device includes a magnetic connection. This allows for a particularly easy-to-install and detachable attachment to the user. The fastening device can have two magnetic elements to form the magnetic connection, one of which is attached to the user and the other of which is attached to the pneumatic line, particularly at the contact point of the sections.

[0019] The invention is explained in more detail below with reference to preferred embodiments and the figures. These show: Fig. 1 a schematic representation of an embodiment of the vitrectomy system; Fig. 2 a schematic representation of another embodiment of the vitrectomy system with a connecting section; Fig. 3 a schematic representation to illustrate an attachment to a user; Fig. 4 a schematic representation of a fastening device with a fastening strap to illustrate a further embodiment of the vitrectomy system; Fig. 5 a schematic representation of a fastening device with a retaining clip to illustrate a further embodiment of the vitrectomy system; Fig. 6 A schematic representation of a fastening element with two connecting sections to illustrate another embodiment of the vitrectomy system.

[0020] The Fig. Figure 1 shows a schematic representation of an embodiment of the vitrectomy system 1. The vitrectomy system 1 comprises a pneumatically operated surgical instrument 2 (in particular a vitrectome), a console 3 which is configured to provide compressed air for operating the surgical instrument 2, and at least one pneumatic line 4 which connects the surgical instrument 2 to the console 3 and through which the compressed air is provided.

[0021] Console 3 includes, for example, a pneumatic switching device (not shown) that periodically switches between a provided quasi-constant pressure and a vent, and thereby drives a cutting edge of the surgical instrument 2 via the pneumatic line 4.

[0022] The at least one pneumatic line 4 has a section 4-1 located away from the instrument and a section 4-2 located near the instrument. The inner diameters 5-1, 5-2 of the sections 4-1, 4-2 of the pneumatic line 4 are the same, while the outer diameter 6-1, 6-2 and / or the material damping of the two sections 4-1, 4-2 differ.

[0023] The one in Fig. The embodiment shown in Figure 1 depicts a single pneumatic line 4. However, in principle, two pneumatic lines 4 can also be provided for dual-pneumatic applications (not shown).

[0024] The Fig. Figure 2 shows a schematic representation of an embodiment of the vitrectomy system 1, which is basically the same as the one described in the Fig. The embodiment shown in Figure 1 is configured as follows. The vitrectomy system 1 includes a connecting section 7 that fluidly connects sections 4-1 and 4-2 of the pneumatic line 4. For this purpose, the connecting section 7 includes, for example, corresponding pneumatic connections for the ends of sections 4-1 and 4-2, for example, in the form of bores specifically designed for this purpose. The inner diameter of the connecting section 7 corresponds to the inner diameter 5-1, 5-2 of sections 4-1 and 4-2.

[0025] It may be provided that the material damping of the section 4-1 furthest from the instrument is smaller than the material damping of the section 4-2 closest to the instrument.

[0026] It may be provided that the wall thickness of the sections 4-1, 4-2, defined by the outer diameter 6-1, 6-2 and the inner diameter 5-1, 5-2, is selected such that the bending stiffness of the section 4-2 closest to the instrument is less than the bending stiffness of the section 4-1 furthest from the instrument.

[0027] It may be provided that a length L1, L2 of sections 4-1, 4-2 (or a total length of the pneumatic line) is chosen taking into account a cutting rate such that an antinode of the compressed air is created at the surgical instrument 2.

[0028] It may be provided that the vitrectomy system 1 includes a fastening device 8 ( Fig. 2 and Fig. 3) comprising a device for attaching the at least one pneumatic line 4 to a user of the surgical instrument 2, wherein the attachment device 8 is arranged at the contact point of sections 4-1, 4-2. The attachment device 8 can, for example, be attached to a garment 9 ( Fig. 3) and / or be attached to the user's forearm 10 or wrist 11. This attachment can, in particular, relieve strain on section 4-2, as it is no longer (or no longer as strongly) coupled to movements of section 4-1.

[0029] It may be provided that the fastening device 8 includes a fastening strap 13. This is shown schematically in the Fig. Figure 4 shows the fastening strap 13 and a fastening element 14 arranged thereon, which is also part of the fastening device 8. The fastening element 14 has a connecting section 7 for fluidically connecting the sections. The fastening element 14 also has an elongated hole 15 through which the fastening strap 13 passes. To prevent snagging on the fastening element 14, the fastening element 14 may have rounded corners and / or a rounded outer contour. The fastening element 14 may, for example, be manufactured as an injection-molded part.

[0030] It may be provided that the fastening strap 13 has a hook and loop fastener 16.

[0031] The Fig. Figure 5 shows a further embodiment of the fastening device 8. In this embodiment, the fastening device 8 comprises a retaining clip 17. The retaining clip 17 includes, in particular, a connecting section 7 for fluidically connecting the sections. Furthermore, the retaining clip 17 includes, in particular, a lower jaw 19 and an upper jaw 20 at an opening 18, by means of which a section of a garment can be grasped and / or gripped. The lower jaw 19 and the upper jaw 20 can have alternately arranged and / or interlocking teeth 21 for this purpose. To prevent snagging on the retaining clip 17, the retaining clip 17 can have rounded corners and / or a rounded outer contour. For example, it can be provided that the distance between the lower jaw and the upper jaw can be adjusted.It may be provided that a material- and / or structure-related restoring force moves the lower jaw 19 and / or the upper jaw 20 from an open position back into a fixed position, thereby facilitating the positioning of the garment area between jaws 19 and 20 and its removal. The retaining clip 17 may, for example, be manufactured as an injection-molded part.

[0032] It may be provided that the fastening device 8 ( Fig. 2) comprises a magnetic connection (not shown). The magnetic connection comprises, in particular, two magnetic elements, one of which is arranged on the user and the other of which is arranged on the pneumatic line 4. For example, the fastening device 8 may include a fastening element 14, such as the one shown in the Fig. Figure 4 shows a fastening element 14, which, however, is not directly attached to the user by means of the fastening band 13, but indirectly by means of the magnetic connection. One of the magnetic elements is then attached to the fastening band 13, and the other magnetic element to the fastening element 14. By forming the magnetic connection between the magnetic elements, the pneumatic line can then be positioned on the user.

[0033] The Fig. Figure 6 shows another embodiment of the fastening device. The fastening device is basically the same as the one shown in the Fig. 4 shown fastening device designed, however the fastening element 14, which is attached to the fastening band, has two connecting sections 7 which fluidically connect the respective sections of two pneumatic lines. Reference sign 1 Vitrectomy system 2 surgical instruments 3 console 4 pneumatic lines 4-1 remote section 4-2 instrument-adjacent section 5-1 Inner diameter remote section 5-2 Inner diameter of the section near the instrument 6-1 Outer diameter remote section 6-2 Outer diameter of the section closest to the instrument 7 Connecting section 8 Fastening device 9. A user's item of clothing 10 Forearm 11 Wrist 13 fastening strap 14 Fastening element 15 elongated holes 16 Velcro fasteners 17 retaining clips 18 Opening 19 Lower jaw 20 upper jaw 21 tooth L1 Length of instrument-remote section L2 Length of instrument-proximal section QUOTES INCLUDED IN THE DESCRIPTION

[0000] This list of documents cited by the applicant was automatically generated and is included solely for the reader's convenience. The list is not part of the German patent or utility model application. The DPMA accepts no liability for any errors or omissions. Cited patent literature

[0000] US 2013 / 0 150 875 A1

[0002] EP 3 600 184 B1

[0003]

Claims

Vitrectomy system (1) comprising: a pneumatically operated surgical instrument (2), a console (3) configured to provide compressed air for operating the surgical instrument (2), and at least one pneumatic line (4) connecting the surgical instrument (2) to the console (3) and through which the compressed air is provided, wherein the at least one pneumatic line (4) has a section (4-1) away from the instrument and a section (4-2) near the instrument, wherein the inner diameters (5-1, 5-2) of the sections (4-1, 4-2) of the pneumatic line (4) are the same, and wherein the outer diameter (6-1, 6-2) and / or the material damping of the two sections (4-1, 4-2) differs. Vitrectomy system (1) according to claim 1 , characterized in that the material damping of the instrument-remote section (4-1) is smaller than the material damping of the instrument-proximal section (4-2). Vitrectomy system (1) according to one of the preceding claims, characterized in that a wall thickness of the sections (4-1,4-2) defined by the outer diameter (6-1,6-2) and the inner diameter (5-1,5-2) is selected such that a bending stiffness of the section (4-2) near the instrument is smaller than a bending stiffness of the section (4-1) farther from the instrument. Vitrectomy system (1) according to one of the preceding claims, characterized in that a length (L1,L2) of the sections (4-1,4-2) is selected taking into account a cutting rate such that an antinode of the compressed air is created at the surgical instrument (2). Vitrectomy system (1) according to one of the preceding claims, characterized by a fastening device (8) which is designed to fasten the at least one pneumatic line (4) to a user of the surgical instrument (2), wherein the fastening device (8) is arranged at the contact point of the sections (4-1,4-2). Vitrectomy system (1) according to claim 5, characterized in that the fastening device (8) has at least one connecting section (7) which is configured to fluidically connect the sections (4-1,4-2) of the pneumatic line (4). Vitrectomy system (1) according to one of claims 5 or 6, characterized in that the fastening device (8) comprises a fastening band (13). Vitrectomy system (1) according to one of claims 5 to 7, characterized in that the fastening strap (13) has a hook and loop fastener (16). Vitrectomy system (1) according to one of claims 6 to 8, characterized in that the fastening device (8) comprises a retaining clip (17). Vitrectomy system (1) according to one of claims 6 to 9, characterized in that the fastening device (8) comprises a magnetic connection.

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